scholarly journals Endotracheal tube cuff pressure management in adult critical care units

2012 ◽  
Vol 28 (1) ◽  
Author(s):  
Portia Janine Jordan ◽  
Dalena Van Rooyen ◽  
Danie Venter
Keyword(s):  
Critical Care ◽  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Endotracheal Tube Cuff ◽  
Pressure Management ◽  
Tube Cuff ◽  
Critical Care Units ◽  
Endotracheal Tube Cuff Pressure

scholarly journals Observational Analysis of Changes in Endotracheal Tube Cuff Pressure During Laparoscopic Surgery

2020 ◽  
Vol 3 (2) ◽  
pp. 46-49
Author(s):  
Hunsehalli Revanasiddappa Narendra ◽  
Aparna Nerurkar ◽  
Shibu Sasidharan
Keyword(s):  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Endotracheal Tube ◽  
Airway Pressure ◽  
Cuff Pressure ◽  
Pressure Gauge ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Observational Analysis ◽  
Endotracheal Tube Cuff Pressure

ABSTRACT Background Laparoscopic surgery is performed under general anesthesia with mechanical ventilation, and a high-volume, low-pressure endotracheal tube (ETT) with a sealing cuff pressure about 20–30 cm of H2O is commonly used for a proper seal and avoidance of overinflation. Nitrous oxide (N2O) is an inhalational anesthetic that is used with oxygen in the ratio 50:50 for the maintenance of anesthesia if there is no facility of medical air. However, N2O increases the intracuff pressure of the tracheal tube due to diffusion of N2O in to cuff during general anesthesia. The present research was done to study the cuff pressure changes during laparoscopic surgeries with N2O anesthesia and to assess its variation during the various stages of surgery and also its correlation with position of the patient. Materials and methods A study was done in a tertiary-level hospital over a period of 1 year in 70 patients undergoing laparoscopic surgery. Endotracheal tube was inflated with incremental doses of 0.5 mL of air to a point where no leak on auscultation on the suprasternal area was noted. Cuff pressure measurement using cuff pressure monitor (Hand pressure gauge) was done at the time of first inflation of cuff up to 20–30 cm of H2O and airway pressure, along with total amount of air inflated was noted as “zero” reading. Thereafter, cuff pressure was measured at regular interval of 5 minutes. Cuff pressures and airway pressures were taken just prior to insufflation, 2 minutes after abdominal insufflation, thereafter every 15 minutes throughout surgery, and 2 minutes after desufflation and prior to extubation. Results Out of 70 patients, maximum patients were of the age-group of 20–50 years (78.5%). There was no statistically significant difference between the groups. Cuff pressure at the induction was kept in range of 20–30 cm of H2O. In this study, mean tracheal cuff pressure at baseline was 21.10 + 6.16 (p value of 0.207) and prior to insufflation was 21 + 7.13 (p value of 0.733). The cuff pressures at 2 minutes post insufflation (P2), P15, P30, P45, and P60 were 31.40 ± 12.54 cm of H2O, 25.79 ± 8.68 cm of H2O, 24.61 ± 7.37 cm of H2O, 23.83 ± 9.43 cm of H2O, and 24.63 ± 4.77 cm of H2O, respectively. p value was strongly significant showing a positive correlation between pneumo-peritoneum and cuff pressures. We could see the cuff pressure continuously increasing in successive readings. Post desufflation and prior to extubation, there was a fall in cuff pressure with mean cuff pressure being 17.24 + 5.32 cm of H2O and 15.27 + 4.00 cm of H2O, respectively, which also suggests that cuff pressures increased with pneumoperitoneum. Conclusion Use of N2O increases the cuff pressure (31.4 + 12.54 cm of H2O), especially immediately post-insufflation (35.54 + 12.06 cm of H2O), more so in head low position (36.28 + 12.13 cm of H2O). Mean airway pressure (Ppeak) also increased with pneumoperitoneum (22.60 + 4.38 cm of H2O). The regular monitoring of endotracheal tube cuff pressure should be a part of regular safe practice of anesthesia, and use of handy device like hand pressure gauge should be implemented in regular practice where N2O is used. How to cite this article Narendra HR, Nerurkar A, Sasidharan S. Observational Analysis of Changes in Endotracheal Tube Cuff Pressure During Laparoscopic Surgery. J Med Acad 2020;3(2):46–49.

scholarly journals The effect of an educational intervention on nurses’ knowledge of managing endotracheal tube cuff pressure in intensive care units: A quasi-experimental study

2019 ◽  
Author(s):  
Ferestas Mpasa ◽  
Dalena R. M. van Rooyen ◽  
Danie Venter ◽  
Wilma ten Ham-Baloyi ◽  
Portia Jordan
Keyword(s):  
Intensive Care ◽  
Endotracheal Tube ◽  
Educational Intervention ◽  
Cuff Pressure ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Post Test ◽  
Quasi Experimental ◽  
Endotracheal Tube Cuff Pressure ◽  
Nurses Knowledge

Abstract Background Previous studies conducted on nurses’ knowledge regarding endotracheal tube cuff pressure revealed that there were differences in intensive care nurses’ knowledge, leading to varying practices. This study aimed to evaluate the effect of an educational intervention based on existing evidence-based guidelines, on the knowledge of nurses regarding managing endotracheal tube cuff pressures in Malawian intensive care units.Methods The study followed a quasi-experimental approach, with a pre- and post-test design using an educational intervention. Intensive care unit nurses were randomly assigned to two intervention groups. Both groups received a half-day educational session, a printed version of the evidence-based guidelines, a printed and laminated summary of the guidelines and a related algorithm. Additionally, Group 2 received four monitoring visits. Pre-and post-test questionnaires were conducted between February and August 2016. Descriptive and inferential data analysis (a chi-square test and t-test) were utilised.Results Knowledge on the nursing care practices for the management of endotracheal tube cuff pressure was improved for both groups following the educational intervention, although only the results comparing the Intervention 2 group participants’ indicate that the level of knowledge were significant (t(d.f.=48)=2.08, p=0.043, d=0.59).Conclusions The implementation of a formal training programme and mentorship programme for nurses working in the intensive care unit in Malawi would be of great benefit to equip nurses with adequate knowledge and skills for managing endotracheal tube cuff pressure. Follow-up studies would also assist in understanding how the implementation of guidelines could be done most effectively to achieve better knowledge outcomes among nurses concerning nursing care practices in this context.

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